title: Prolonged preoperative hospital stay is a risk factor for complications after emergency colectomy for severe colitis.
abstract: OBJECTIVE
  Risk factors for postoperative complications in patients undergoing emergency colectomy for severe colitis in inflammatory bowel disease have hardly been studied. Therefore, this study aimed to define predictors of a complicated postoperative course in these patients.
  
  
  METHODS
  A retrospective review was performed of 71 consecutive patients who underwent emergency colectomy for severe colitis between 1999 and 2012 at a tertiary referral centre. Complications were graded according to the Clavien-Dindo classification. Patients with a complication Grade II or higher were compared with those with no complications or a Grade I complication.
  
  
  RESULTS
  Nineteen patients (26.7%) had at least one postoperative complication classified as Clavien-Dindo Grade II or higher. In the group with postoperative complications, patients had a higher age (mean 45 vs 35 years, P = 0.020) and a higher body mass index (BMI) (mean 25.9 vs 21.0 kg/m(2), P = 0.006). Length of preoperative hospital stay (median 15 vs 6 days, P = 0.032) was longer in the group with postoperative complications. During the study period, the preoperative hospital stay decreased by 0.8 days per study year (95% CI 0.2-1.5 days, P < 0.001). This did not influence the complication rate over time, however.
  
  
  CONCLUSIONS
  Factors increasing the risk of complications after emergency colectomy for severe colitis were a higher age, a higher BMI and a longer preoperative hospital stay.
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: S A L
authors.initials: SA
authors.lastname: Bartels
authors.forename: T J
authors.initials: TJ
authors.lastname: Gardenbroek
authors.forename: L
authors.initials: L
authors.lastname: Bos
authors.forename: C Y
authors.initials: CY
authors.lastname: Ponsioen
authors.forename: G R A M
authors.initials: GR
authors.lastname: D'Haens
authors.forename: P J
authors.initials: PJ
authors.lastname: Tanis
authors.forename: C J
authors.initials: CJ
authors.lastname: Buskens
authors.forename: W A
authors.initials: WA
authors.lastname: Bemelman
mesh_terms: D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D003082:Colectomy / Q000009:adverse effects*; D003092:Colitis / Q000209:etiology / Q000601:surgery*; D003093:Colitis, Ulcerative / Q000601:surgery; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D057234:Preoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Inflammatory bowel disease; gastroenterology; surgery